PDF(Pubmed)
Abstract：
UNASSIGNED: An effective referral system is necessary to ensure quality and an optimum continuum of care. In the Kingdom of Saudi Arabia, an e-referral system known as the Saudi Medical Appointments and Referrals Centre (SMARC), has been fully functioning since 2019. This study aims to explore the rate of medical e-referral request acceptance in the KSA, and to study the factors associated with acceptance.
UNASSIGNED: This period cross-sectional study utilised secondary collected data from the SMARC e-referral system. The data spans both 2020 and 2021 and covers the entirety of the KSA. Bivariate analyses and binary logistic regression analyses were performed to compute adjusted Odds Ratios (aORs) and 95% confidence intervals.
UNASSIGNED: Of the total 632,763 referral requests across the 2 years, 469,073 requests (74.13%) were accepted. Absence of available machinery was a significant predictor for referral acceptance compared to other reasons. Acceptance was highest for children under 14 with 28,956 (75.48%) and 63,979 (75.48%) accepted referrals, respectively. Patients requiring critical care from all age groups also had the highest acceptance including 6,237 referrals for paediatric intensive care unit (83.54%) and 34,126 referrals for intensive care unit (79.65%). All lifesaving referrals, 42,087 referrals, were accepted (100.00%). Psychiatric patients were observed to have the highest proportion for accepted referrals with 8,170 requests (82.50%) followed by organ transplantations with 1,005 requests (80.92%). Sex was seen to be a significant predictor for referrals, where the odds of acceptances for females increased by 2% compared to their male counterparts (95% CI = 1.01-1.04). Also, proportion of acceptance was highest for the Eastern business unit compared to all other units. External referrals were 32% less likely to be accepted than internal referrals (95% CI = 0.67-0.69).
UNASSIGNED: The current findings indicate that the e-referral system is mostly able to cater to the health services of the most vulnerable of patients. However, there remains areas for health policy improvement, especially in terms of resource allocation.
UNASSIGNED: This period cross-sectional study utilised secondary collected data from the SMARC e-referral system. The data spans both 2020 and 2021 and covers the entirety of the KSA. Bivariate analyses and binary logistic regression analyses were performed to compute adjusted Odds Ratios (aORs) and 95% confidence intervals.
UNASSIGNED: Of the total 632,763 referral requests across the 2 years, 469,073 requests (74.13%) were accepted. Absence of available machinery was a significant predictor for referral acceptance compared to other reasons. Acceptance was highest for children under 14 with 28,956 (75.48%) and 63,979 (75.48%) accepted referrals, respectively. Patients requiring critical care from all age groups also had the highest acceptance including 6,237 referrals for paediatric intensive care unit (83.54%) and 34,126 referrals for intensive care unit (79.65%). All lifesaving referrals, 42,087 referrals, were accepted (100.00%). Psychiatric patients were observed to have the highest proportion for accepted referrals with 8,170 requests (82.50%) followed by organ transplantations with 1,005 requests (80.92%). Sex was seen to be a significant predictor for referrals, where the odds of acceptances for females increased by 2% compared to their male counterparts (95% CI = 1.01-1.04). Also, proportion of acceptance was highest for the Eastern business unit compared to all other units. External referrals were 32% less likely to be accepted than internal referrals (95% CI = 0.67-0.69).
UNASSIGNED: The current findings indicate that the e-referral system is mostly able to cater to the health services of the most vulnerable of patients. However, there remains areas for health policy improvement, especially in terms of resource allocation.
摘要：
■有效的转诊系统是必要的，以确保质量和最佳的连续护理。在沙特阿拉伯王国，被称为沙特医疗预约和转诊中心（SMARC）的电子转诊系统，自2019年以来一直充分发挥作用。本研究旨在探讨KSA中医疗电子转诊请求的接受率，并研究与接受相关的因素。
■本期间的横断面研究利用了从SMARC电子转诊系统收集的次要数据。数据涵盖了2020年和2021年，涵盖了整个KSA。进行双变量分析和二元逻辑回归分析以计算调整的赔率比(aOR)和95%置信区间。
■在过去两年的632,763个推荐请求中，469,073个请求（74.13%）被接受。与其他原因相比，缺乏可用的机制是转诊接受的重要预测因素。14岁以下儿童的接受度最高，有28,956人(75.48%)和63,979人(75.48%)接受了转介，分别。所有年龄组需要重症监护的患者的接受度最高，包括6,237例儿科重症监护病房转诊（83.54％）和34,126例重症监护病房转诊（79.65％）。所有救生推荐，42,087个推荐，被接受(100.00%)。观察到精神病患者接受转诊的比例最高，有8,170个请求（82.50％），其次是器官移植，有1,005个请求（80.92％）。性别被认为是转诊的重要预测因素，与男性相比，女性的接受几率增加了2%(95%CI=1.01-1.04)。此外，与所有其他单位相比，东部业务部门的验收比例最高。接受外部转诊的可能性比接受内部转诊的可能性低32％（95％CI=0.67-0.69）。
■目前的研究结果表明，电子转诊系统主要能够满足最脆弱患者的医疗服务。然而,卫生政策仍有改进的地方，特别是在资源分配方面。
■本期间的横断面研究利用了从SMARC电子转诊系统收集的次要数据。数据涵盖了2020年和2021年，涵盖了整个KSA。进行双变量分析和二元逻辑回归分析以计算调整的赔率比(aOR)和95%置信区间。
■在过去两年的632,763个推荐请求中，469,073个请求（74.13%）被接受。与其他原因相比，缺乏可用的机制是转诊接受的重要预测因素。14岁以下儿童的接受度最高，有28,956人(75.48%)和63,979人(75.48%)接受了转介，分别。所有年龄组需要重症监护的患者的接受度最高，包括6,237例儿科重症监护病房转诊（83.54％）和34,126例重症监护病房转诊（79.65％）。所有救生推荐，42,087个推荐，被接受(100.00%)。观察到精神病患者接受转诊的比例最高，有8,170个请求（82.50％），其次是器官移植，有1,005个请求（80.92％）。性别被认为是转诊的重要预测因素，与男性相比，女性的接受几率增加了2%(95%CI=1.01-1.04)。此外，与所有其他单位相比，东部业务部门的验收比例最高。接受外部转诊的可能性比接受内部转诊的可能性低32％（95％CI=0.67-0.69）。
■目前的研究结果表明，电子转诊系统主要能够满足最脆弱患者的医疗服务。然而,卫生政策仍有改进的地方，特别是在资源分配方面。
